Neoplasia Exam #4

Question 1

Neoplasia - Proto-oncogenes versus Tumor Suppressors – differences?

Answer 1

Proto-oncogenes: These are normal genes that promote cell growth and division. They are like the “accelerators” of cell proliferation. When mutated or overexpressed, they can become oncogenes, leading to uncontrolled cell division and contributing to cancer development.

Tumor Suppressor Genes: These genes inhibit cell growth and division, acting as “brakes” on cell proliferation. They help prevent cells from dividing too quickly or uncontrollably. When tumor suppressor genes are inactivated or lost due to mutations, the regulatory control is compromised, allowing cancer to develop.

Question 2

Cell types (neoplasia)

Answer 2

carcinoma, sarcoma, leukemias and lymphomas

Question 3

Neoplasia (three traditional treatments)

Answer 3

– S, R, Chemotherapy

Primary, neoadjuvant, adjuvant

Question 4

Neoplasia Toxicity

Answer 4

attacks rapidly dividing cells

Nausea & Vomiting, Bone marrow depression, Alopecia, Abortion, fetal death, teratogenicity, Carcinogenicity, Immunosuppression

Question 5

Alkylating Agents

Answer 5

Largest and most diverse class

Either alkylate DNA or interfere by crosslinking (platinum compounds

Question 6

Alkylating Agents Groups

Answer 6

Nitrogen Mustards
- Cyclophosphamide – cancer and immunosuppressive
- Chlorambucil – least toxic

Nitrosureas – cross BBB

Alkyl Sulfonate

Platinum Analogs
Cisplatin, carboplatin

Question 7

Cisplatin

Answer 7

• Highly bound to plasma proteins
• Concentrates in kidney, intestine, testes
• Poorly penetrates BBB
• Slowly excreted in urine

Question 8

Cisplatin uses:

Answer 8

• Testicular cancer (85% - 95 % curative )
• Ovarian cancer
• Other solid tumors: lung, esophagus, gastric

Question 9

Methotrexate

Answer 9

Inhibits dihydrofolate reductase (DHFR) – Interferes with DNA/RNA synthesis

Question 10

Methotrexate actions (3)

Answer 10

Cytotoxic actions
- Predominant on bone marrow
- Ulceration of intestinal mucosa
- Crosses placenta interferes with embryogenesis - fetal malformations and death

Immunosupressive action
- Prevents clonal expansion of B & T lymphocytes

Anti-Inflammatory action
- Interferes with release of inflammatory cytokines

Question 11

6-MP, 5-FU

Answer 11

Antimetabolites

Question 12

Vincristine, Paclitaxel (Taxol)

Answer 12

Plant Based - chemotherapy

Question 13

Dactinomycin, Doxorubicin, Bleomycin

Answer 13

Antibiotics - chemotherapy

Question 14

Corticosteroids, Tamoxifen, Fulvestrant

Answer 14

Hormonal Agents - chemotherapy

Question 15

Imatinib, Trastuzumab, Rituximab

Answer 15

Miscellaneous - chemotherapy drugs

Question 16

Immunosuppressive Agents - Categories

Answer 16

Glucocorticoids (corticosteroids)
Calcineurin Inhibitors
Cytotoxic Agents
Immunosuppressive Antibodies
Additional Agents

Question 17

nitrosourceas

Answer 17

one of the Alkylating Agents that cross BBB

Question 18

chlorambucil

Answer 18

The least toxic nitrogen mustards that are under the Alkylating Agents class

Question 19

cyclophosphamide

Answer 19

Cytotoxic agents (kill rapidly proliferating cells) used for cancer and immunosuppressive (alkylating agents)